Hepatic Encephalopathy Due to Intrahepatic Portosystemic Venous Shunt Successfully Treated by Interventional Radiology

Atsushi HIRAOKA; Kiyotaka KUROSE; Maho HAMADA; Nobuaki AZEMOTO; Yoshio TOKUMOTO; Masashi HIROOKA; Aki HASEBE; Teru KUMAGI; Mami HIRATA; Kojiro MICHITAKA; Hisaka MINAMI; Masato MURAKAMI; Yoshinori ISOBE; Norio HORIIKE; Morikazu ONJI

doi:10.2169/internalmedicine.44.212

CASE REPORTS

Hepatic Encephalopathy Due to Intrahepatic Portosystemic Venous Shunt Successfully Treated by Interventional Radiology

Atsushi HIRAOKA, Kiyotaka KUROSE, Maho HAMADA, Nobuaki AZEMOTO, Yoshio TOKUMOTO, Masashi HIROOKA, Aki HASEBE, Teru KUMAGI, Mami HIRATA, Kojiro MICHITAKA, Hisaka MINAMI, Masato MURAKAMI, Yoshinori ISOBE, Norio HORIIKE, Morikazu ONJI

Author information

Atsushi HIRAOKA
Third Department of Internal Medicine, Ehime University of Medicine
Kiyotaka KUROSE
Third Department of Internal Medicine, Ehime University of Medicine
Maho HAMADA
Third Department of Internal Medicine, Ehime University of Medicine
Nobuaki AZEMOTO
Third Department of Internal Medicine, Ehime University of Medicine
Yoshio TOKUMOTO
Third Department of Internal Medicine, Ehime University of Medicine
Masashi HIROOKA
Third Department of Internal Medicine, Ehime University of Medicine
Aki HASEBE
Third Department of Internal Medicine, Ehime University of Medicine
Teru KUMAGI
Third Department of Internal Medicine, Ehime University of Medicine
Mami HIRATA
Department of Internal Medicine, Matsuyama Joto Hospital, Ehime
Kojiro MICHITAKA
Endoscopy Center, Ehime University of Medicine
Hisaka MINAMI
Third Department of Internal Medicine, Ehime University of Medicine
Masato MURAKAMI
Department of Internal Medicine, Murakami Memorial Hospital, Ehime
Yoshinori ISOBE
Department of Radiology, Kitasato University East Hospital, Kanagawa
Norio HORIIKE
Third Department of Internal Medicine, Ehime University of Medicine
Morikazu ONJI
Third Department of Internal Medicine, Ehime University of Medicine

Keywords: intrahepatic portosystemic shunt, hepatic encephalopathy, liver dysfunction, transcatheter embolization

JOURNAL OPEN ACCESS

2005 Volume 44 Issue 3 Pages 212-216

DOI https://doi.org/10.2169/internalmedicine.44.212

Details

Abstract

We treated a 66-year-old woman with hepatic encephalopathy secondarily induced by an intrahepatic portosystemic venous shunt (IPSVS). In serial observations, the volume of the liver became smaller and encephalopathy could not be controlled with conservative therapy. We occluded the IPSVS successfully using percutaneous transcatheter embolization with micro coils. Following embolization, encephalopathy disappeared and blood flow of all branches of portal vein improved. In cases with an IPSVS without liver cirrhosis, blood flow in the portal vein and liver volume must be followed carefully, and interventional radiology may be considered effective in those who do not show a satisfactory response to conservative therapy.

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